An advance care planning bill introduced in California has recently passed in the state Senate. Gov. Gavin Newsom (D) is now considering the legislation.
If enacted, the legislation would introduce provisions to existing advance care planning options designed to improve access to goal-concordant care.
Sen. Catherine Blakespear (D-38) introduced the bill.
“This legislation puts patients first and ensures their medical wishes are honored when they matter most,” Blakespear said in a statement. “People should get the end-of-life care they want, even if they are incapacitated or can no longer express their wishes.”
Three types of advance care planning forms currently exist in California. The options include advance directives, as well as Do Not Resuscitate (DNR) and Physician Orders for Life Sustaining Treatment (POLST) forms.
The new bill proposes changes that would be designed to ensure greater consistency and more effective utilization of the state’s advance care planning forms. Among the provisions are clarifications for designating decision makers or proxies for advance care directives. The legislation also proposed to add sections on POLST forms that would give healthcare providers more guidance on patients’ preferences related to medical interventions and treatments.
The legislation follows the previously introduced End-of-Life Option Act, which relates to California’s medical aid in dying laws and is set to expire in 2031.
The new bill could allow greater insight into goal concordant care outcomes, according to Sheila Clark, president and CEO, California Hospice and Palliative Care Association (CHAPCA). If enacted, the legislation could improve access and quality as patients near the end of life, Clark said.
“Legislation like this tells us that we are looking more closely at whether the care being delivered is actually the care the patient wanted,” Clark told Hospice News in an email. “That is important for both access and quality, particularly when patients are facing serious illness and may benefit from hospice or palliative care.”
Some hospice patients see frequent transitions of care across multiple settings, often moving between hospitals, hospice, skilled nursing facilities and home health. These transitions can be burdensome, with patients and families repeatedly explaining established and documented healthcare decisions, Clark indicated.
For hospices, the issue is directly connected to goal-concordant care delivery, she stated.
“From what our hospice and skilled home health members see every day, this really comes down to making sure a patient’s wishes follow the patient,” Clark said. “Advance care planning cannot become another form or checkbox. The conversation with the patient and family is what matters, and that conversation continues as the patient’s condition and wishes change.”
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